Electronic Health Record Implementation Paper
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The adoption of electronic health records has shaped significantly the provision of healthcare in the modern world. Electronic health records have made it possible for health organizations to obtain, organize, analyze and present data for the healthcare providers’ use in decision-making. The costs of healthcare have also declined significantly with the use of electronic health records. The reduction is attributed to the enhanced efficiency in the decision-making process and the provision of healthcare. There is also the enhanced provision of safe, high quality care that meets the actual and perceived needs of the diverse populations. Therefore, this research paper examines the roles of the registered nurse in various scenarios related to the use of electronic health records.
Database to Track Opportunities for Care Improvement Information
Health information systems should not only provide enhanced efficiencies in data use but also tracking for opportunities in healthcare too. Different kinds of information are needed to allow for tracking of healthcare opportunities. One of them is information on patient satisfaction. The systems should allow organizations to obtain data related to the level of patient satisfaction with care. The patients should also provide their feedback on areas of improvement that would result in better services to those in need (Sarkar, 2015). Such information is important since the organization learns more about the ways in which excellent services can be offered to meet the diverse needs of the patients.
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The other information that is needed in the database is information on appointment processes. The organization needs to be available for the populations in need at all times. It is therefore important that information on the duration that it takes from the time of requesting an appointment to the actual appointment is obtained. Information on effectiveness of the reminders of appointment and missed or cancelled appointment should also be kept in the database. The above information is needed to evaluate the responsiveness of the organization to its consumers (Graña, Toro, & Howlett, 2015). The company can optimize such information by ensuring that patients receive excellent services from booking appointments, actual appointments, reminders, and finding out about the reasons for missed or cancelled appointments.
The other type of information that is needed in the database for tracking opportunities in healthcare is information on the quality of treatment offered to those in need. The nature of care given to the patients should be safe, effective, and quality. It should optimize on patient outcomes such as faster recovery, safety, cost-effectiveness, and minimize adverse events. Therefore, information such as those related to prescription, referral tracking, and result tracking can be used to improve the quality of treatment.
Role of Informatics in Capturing the Above Data
Health informatics plays an important role in capturing the above data that is used for tracking opportunities in healthcare. It promotes the provision of patient-centered care. It also provides a mechanism in which patients and healthcare providers exchange vital information for improving healthcare outcomes. The information can be shared with other healthcare providers for the purposes of collaborative provision of healthcare. Through it, shared decision-making is promoted since patients have more control over the planning of their healthcare needs. Informatics also provides opportunities for error minimization in the use of the collected data. For instance, standards of information used are developed to guide the interpretation of each category of data and its implications to healthcare, thereby, promoting meaningful use of the obtained data.
Systems and Staff Needed in the Design and Implementation Process and Team
The type of system to be selected depends largely on the needs of an organization. However, it is important that the selected system promote flexibility and ease use by the healthcare providers. It should enhance patient-healthcare provider interaction rather than deterring the nature of communication between them. The electronic health record is one such system. Therefore, the user interface of the selected system should be intuitive as well as easy to learn. The simplicity ensures that there is easy transition for the users and enhanced system effectiveness in delivering the needed productivity.
The staff that are needed in the design and implementation of healthcare technologies should comprise of administrative staff, medical assistants, nurses, lead super user, information technology professionals, and physicians. They are needed in the design process as they provide their input on system features that should be included in the system. They are also needed in the implementation phase as they determine the usability of the system and ease of use. The staffs work as teams throughout the process of system design to evaluation.
Professional, Ethical, and Regulatory Standards that must be incorporated into Design and Implementation of the System
The design and implementation of electronic health systems are done with a consideration of professional, ethical, and regulatory standards. According to the American Nurses Association, healthcare information technologies should promote patient safety as well as enhanced patient outcomes. The data should be accurately as well as efficiently obtained, recorded, stored, analyzed, and reported. Ethical principles that guide the use of electronic health data should also be considered. This includes the principles of confidentiality, privacy, and security of electronic health data. The healthcare providers should also play an active role in the design, implementation, and evaluation of system use in their organizations (Stanhope & Lancaster, 2016).
Regulatory standards must also be incorporated into the design and implementation of health electronic systems. An example is the consideration of the provisions of the Health Information Technology for Economic and Clinical Health Act (HITECH) and HIPAA security standards. According to HIPAA, institutions of healthcare should take the responsibility of protecting the health data of their patients. The principles of privacy, confidentiality, and security should be upheld for efficient and effective use of electronic health data. The HITECH Act provides stricter measures that underpin the provisions of HIPAA standards (Sarkar, 2015). It increases the legal liability for any incidence of non-compliance to HIPAA provisions on the use and protection of electronic health data.
How EHR Team Will Ensure that All Order Sets Are Part of the New Record
The EHR team can use a four-step process to ensure that order sets are part of the new record. The steps include coming up with a system of governance for the order set structure, planning and tracking the maintenance and workflow of the order set, creating and making use of style guide that promote consistency, and encouraging practices that streamline order set use in clinical environment. The first step, governance, entails formulating a body to support communication as well as decision making for project coordination, integration, and customization. The governance group can comprise of any staff members and tasked with responsibilities such as providing oversight, establishing use of metrics, and communicating with other stakeholders. In the second step, planning, the expectations, goals, and deadlines of order sets are developed. The existing order sets are edited and integrated into the new systems. The third step, style guide, entails the development of an approach that will promote consistency in aspects such as layout, naming, order set sequencing, types of evidence, and size thresholds. Consistency in these aspects is important as it ensures easy search as well as data retrieval, use, and standardization. In the last step, physician engagement, the staffs involved in the use of order set are invited to review the system. Approaches such as webinars and meetings are used to create awareness among the users (Kelley, 2016). Healthcare provider involvement is critical as it ensures effective adoption of system use in the organization.
How to Communicate Changes in the Plan
Formal means of communication should be utilized in the design and implementation of electronic health systems. These include the use of posters, email, and arranging for meetings with the staff to communicate the progress, needs, and any alterations. These formal methods of communication create awareness among the healthcare providers on the needs of the electronic health systems, thereby, minimizing resistance to system adoption by the staffs. The communication should also be timely and updated to avoid any cases of surprises to the adopters. The environment of the organization should also foster open and free communication (Graña, Toro & Howlett, 2015). The staffs should be able to offer their inputs on the system design and implementation.
Measures and Steps to Evaluate the Success of EHR Implementation from Staff Setting and Patient’s Perspective
Measures of success of EHR implementation are varied. They include adoption process, culture, network and infrastructure efficiency, medical errors, and staff satisfaction with the system. The steps involved in the evaluation of success of EHR include planning, performing calculations on return on investment, assessing system efficiency, assessing quality of care with system, adoption, and evaluation of data input as well as quality. The team should conduct cost-benefit analysis to determine the profitability of the system to the organization and patients. The efficiency is evaluated by using data on patient throughput. The quality of healthcare is determined using surveys on patient satisfaction. Surveys are also administered to the physicians to determine their satisfaction and adoption process. Error rate is determined to evaluate the quality of data input (Gliklich et al., 2014). Through these methods, it is possible to evaluate the implementation of EHR.
Leadership Skills and Theories
Some of the leadership skills that one should have include effective communication, problem solving, project management, and technical proficiency. Open communication is important as it keeps the stakeholders aware of the progress of the implementation. It also ensures that team members communicate their concerns and ways of improving outcomes. The design and implementation of EHR involves people with diverse knowledge, experience, and perceptions. The diversity increases the risk of conflicts, which needs individuals with adept experience in problem solving. The members should also have experience in project management since it demands the setting and evaluation of various deliverables. Technical proficiency is needed to facilitating the understanding of information technology-related terms that are used in the process. The leadership theories that are needed include participatory and transformative leadership styles (Barrett, 2015). In participatory style, all the stakeholders are encouraged to play an active role in the whole project. It focuses on empowering the team members involved in the adoption process. In transformative leadership, the focus is placed on ensuring that individuals work collectively to achieve a common goal. The leaders influence those they lead through encouraging, inspiring, and motivating them to explore innovative ways of doing things.
Conclusion
In summary, electronic health records can be utilized to not only improve the quality of care but also identify opportunities in the healthcare system too. The stored data can be used to explore the trends that can be explored for business profitability. The design and implementation of electronic health records is a collaborative process. It incorporates the insights provided by stakeholders such as doctors, nurses, and information technology experts. Therefore, it is important that the desired leadership style and skills are employed to ensure that the adopted system meets the prioritized needs of the organization.
References
Barrett, A. K. (2015). Change is inevitable but compliance is optional: Coworker social influence and behavioral work-arounds in the EHR implementation of healthcare organizations. Austin, Tex: University of Texas.
Gliklich, R. E., Dreyer, N. A., Leavy, M. B., Quintiles Outcome (Firm),, United States., & Effective Health Care Program (U.S.). (2014). Registries for evaluating patient outcomes: A user’s guide. Rockville, MD: Agency for Healthcare Research and Quality.
Graña, M., Toro, C., & Howlett, R. J. (2015). Innovation in Medicine and Healthcare 2014. Burke: IOS Press.
Kelley, T. (2016). Electronic health records for quality nursing & health care. Lancaster, PA: DEStech Publications.
Sarkar, I. N. (2015). MEDINFO 2015: eHealth-enabled Health. IOS Press.
Stanhope, M., & In Lancaster, J. (2016). Public health nursing: Population-centered health care in the community. St. Louis, Missouri: Elsevier.
Benchmark – Electronic Health Record Implementation paper. This benchmark assignment assesses the following programmatic competencies
Benchmark – Electronic Health Record Implementation paper. This benchmark assignment assesses the following programmatic competencies: Develop leadership skills to collaborate on interprofessional teams in the provision of evidence-based, patient-centered care. Apply professional, ethical, and regulatory standards of practice in the provision of safe, effective health care.
One way informatics can be especially valuable is in capturing data to inspire improvements and quality change in practice. The Agency for Healthcare Research and Quality (AHRQ) collects data related to adverse events and safety concerns. If you are working within a practice setting to implement a new electronic health record (EHR) system, this is just one of the many considerations your team would need to plan for during the rollout process.
In a paper of 1,250-1,500 words, address the following questions related to the advanced registered nurse’s role during this type of scenario:
1) What key information would be needed in the database that would allow you to track opportunities for care improvement?
2) What role does informatics play in the ability to capture this data?
3) Which systems and staff members would need to be involved in the design and implementation process and team?
4) What professional, ethical, and regulatory standards must be incorporated into the design and implementation of the system?
5)How would the EHR team ensure that all order sets are part of the new record?
6) How would you communicate the changes, including any kind of transition plan?
7) What measures and steps would you take to evaluate the success of the EHR implementation from a staff, setting, and patient perspective?
8) What leadership skills and theories would facilitate collaboration with the interprofessional team and provide evidence-based, patient-centered care?
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Quality improvement in patient care is one of the ways in which healthcare organizations achieve their desired goals and objectives. The improvement in quality of care is achievable using methods such as the utilization of electronic health records (EHR) to optimize on care outcomes. Electronic health records enable health organizations to achieve their desired efficiency, quality and safety in the use of health technologies in patient care. They use it in data collection, organization, analysis, and retrieval for easy decision making on the care needs by the patients. Therefore, the purpose of this paper is to explore the opportunities that exist for tracking care information with the adoption of a new electronic health records system. It also focuses on the roles of informatics in the new system as well as those of the advanced registered nurse in the use of health information systems and the leadership styles and approaches needed to facilitate the success of the process.
Key Information in the Database
The newly adopted system should enable opportunities for tracking improvements in the organization. The database should therefore contain a number of information that would be used for tracking improvements. One of the information relates to those for tracking patient response to treatment. The database should be able to capture the problems of patients at the time of contact with the provider, the adopted interventions, and assessment of their effectiveness in facilitating health, wellbeing and recovery. The other information is the demographics of the patient. The database should be able to capture the key demographic data that relates to health. The information will be used for tracking trends of health problems in the population. An additional information is progress notes, diagnostic, and laboratory information. The information will be used for evaluating the need for specific interventions and their effectiveness in facilitating the effective management of the health problem. The other type of information relates to indicators of safety and quality in the organization (Hussey & Kennedy, 2021). The database should capture information such as rates of adverse events in the organization to enable the determination of safety and quality of care given to patients in the institution.
Role of Informatics
Informatics plays a critical role in the ability to capture the above information. Firstly, informatics comprises clinical tools as well as applications that facilitates the capturing of health-related data in the electronic databases. The capture data is important for use in advancing the medical care that patients receive. The informatics applications and tools also organize the data obtained from different sources of care in the organization (Sipes, 2019). It organizes the data into forms such as the electronic medical records and devices for tracking health. The organization of data seeks to ensure efficiency in use in making clinical decisions. Informatics also enables easy retrieval of information by the healthcare providers. Accordingly, healthcare providers have enhanced opportunities to access stored data whenever needed to facilitate decision-making. Besides capturing, storing, and retrieval, informatics has security systems embedded in them to ensure data integrity (Barrett, 2018). The systems have advanced levels of security that eliminates any potential access of the private and confidential data by unauthorized parties.
Systems and Staff Members
The successful implementation of the new EHR system will require the use of a number of systems as well as the involvement of different staff members. There is a need for systems such as billing, documentation, and reimbursement systems. There is also the need for systems to facilitate e-prescribing, telehealth, and report generation. The reimbursement and billing system will enhance the efficiency of paying for healthcare services and making insurance claims. The e-prescribing will be used to order electronic prescriptions for patients. The documentation system will be used for keeping the health records of the patients. The report generation system will be used in developing summaries of healthcare services given and their effectiveness in delivering the expected institutional outcomes (Hussey & Kennedy, 2021).
The staff that will be involved in the project will be varied. They will include nurses, physicians, IT officer, system developer, and project manager. Nurses and physicians will be the direct adopters of the new electronic health records system. Their involvement in the implementation entails ensuring that the system is user-friendly and facilitates their needs in the provision of patient care. The IT officer will provide the technical support needed for the efficient use of the new system. The system developer will train the staffs on the use of the new system. The developer will also address any technical issues that may be experienced with the use of the system in patient care. The project manager will oversee the whole process of implementation (Hussey & Kennedy, 2021). The manager will ensure efficient use of resources to achieve optimum outcomes with the newly adopted system.
The advanced registered nurse will play a number of roles in promoting-evidence based practice and leading quality and performance improvement initiatives within the setting. Firstly, the nurse will ensure the use of evidence-based interventions in the use implementation of the new system. The nurse will use their knowledge and skills gained in nursing informatics to influence the utilization of best interventions in the implementation process. The advanced registered nurse will also act as coach and mentor in the use of the new system (Cowie et al., 2017). They will promote competency development in the users of the new system for the realization of the desired goals in its use in the organization.
Strategies for Implementing the New EHR Proposal
The successful implementation of the new EHR proposal will require the consideration of a number of strategies. One of them will be communication. The users of the new system will be informed about the intended changes in EHR system. Communication will be achieved through internal memos in the organization. The second strategy will be training. The users will be trained to ensure they are competent in using the new system. Training will also minimize the risk of resistance to change from the users (Hussey & Kennedy, 2021). The implementation process will also be systematic. Accordingly, new order sets related to the system will be introduced gradually for use in the organization, as the old system is replaced. A plan for human resource management during the implementation will also be developed. The plan will guide the use of the allocated resources as well as the evaluation of whether the set goals and objectives of the new system are being achieved (Barrett, 2018). Regular assessments will be done to ensure that continuous quality improvement is achieved in system implementation process.
Professional, Ethical and Regulatory Standards
Professional, ethical, and regulatory standards should be incorporated into the implementation of the new electronic health records system. The professional regulatory standards that must be considered include undertaking risk analysis of the system as well as acquiring HIPAA compliance certificate. A risk analysis will enable the identification of institutional weaknesses that should be addressed for the efficient use of the new system (Rathert et al., 2019). The organization also has to obtain HIPAA certificate to ensure that its practices align with those of the regulation as well as promoting the safe use of information technologies in healthcare. The institution should abide with the regulatory provisions of HIPAA and HITECH regulations by performing regular assessment of the systems and undertaking the necessary improvements. The institution should also train its providers on a regular basis to ensure the staffs have the needed competencies in ensuring safe use of the new system. Ethical standards must also be adhered to in the adoption of the new system. The institution and its staffs must ensure the protection of data privacy and confidentiality. They ensure the safe use of health information system by eliminating unintended access and use of the patient data. The healthcare providers must also demonstrate their compliance with HITECH and HIPAA regulations in all the processes of the new system use such as assessment, planning, implementation, monitoring, and evaluation (Hussey & Kennedy, 2021).
Evaluating Success
The success of the new EHR system will be evaluated from staff, setting, and patient perspectives to determine the effectiveness of the system as well as ensure continuous quality improvement. Surveys will be administered to the staffs to obtain information about their experiences with the new system. The surveys will provide information about the success of the new system and the things that should be improved to facilitate its optimum functioning. Questionnaires and surveys will also be administered to the patients. Patients will provide crucial information about their subjective experiences with the care given in the organization. They will provide information related to their perceived safety, quality, and efficiency of care they receive in the organization. The evaluation of the new system from the perspective of the setting will focus on safety and quality metrics of care (Sipes, 2019). It will focus on aspects such as timeliness of care, changes in safety and adverse events, and cost-efficiency and effectiveness of its operations.
Leadership Skills and Theories
